On July 26, 2017, the Seventh Circuit Court of Appeals affirmed a Wisconsin federal district court’s denial of qualified immunity to a jail guard and privately-contracted nurse after they ignored a prisoner’s risk assessment indicating a maximum risk of suicide.

Ryan L. Clark’s breath test showed he had a blood alcohol content level of 0.27, over three times the legal limit for driving, when he was booked into the Green Lake County Jail for violating the terms of his extended supervision. The supervision was from his fifth conviction for operating a motor vehicle under the influence of alcohol, and this was the eighth time his extended supervision supervisor had requested he be placed on “hold” for violating the terms of his supervision by drinking alcohol.

Clark had a history of alcoholism and depression. The jail had previously documented his serious risk of suicide, including instances of self-harm and a suicide attempt the previous year. Each time he had been admitted into the facility he was placed on Special Observation Watch, requiring observation every 15 minutes as a suicide prevention measure.

Officer Bruce Walker performed the intake process, including the administration of the Spillman Initial Inmate Assessment – a computer program that includes a suicide risk assessment generated by evaluating a prisoner’s response to certain questions. The Spillman Assessment showed Clark was at “maximum risk” of committing suicide. Nonetheless, Walker did not implement the jail’s suicide prevention protocol – special precautions for prisoners at risk of harming themselves, which included placing them in a suicide prevention cell under Special Observation Watch.

Instead, Walker put Clark in a holding cell to await a routine medical examination by privately-contracted jail nurse Tina Kuehn, an employee of Correctional Healthcare Companies, leaving the Spillman Assessment for her to review. Nurse Kuehn noted that Clark said he was taking antidepressants but could not remember the name of the medication. She placed the Spillman Assessment in his medical chart, though did not refer him to a mental health counselor or initiate the jail’s suicide prevention protocol.

Clark was then put in a detoxification cell where he was left alone. Four days later, he committed suicide by hanging. According to surveillance video, his body was discovered an hour after he hanged himself, following 30 minutes of preparation.

Clark’s estate filed a federal civil rights complaint against Walker, Kuehn and other defendants. Walker and Kuehn moved for summary judgment based on qualified immunity, which was denied. They filed interlocutory appeals.

The Seventh Circuit held that because nurse Kuehn was a privately-contracted medical provider, she was not entitled to qualified immunity. Further, summary judgment based on qualified immunity was inappropriate because Clark had a constitutional right – clearly established by circuit precedent – to be free of deliberate indifference to his risk of suicide.

The appellate court found numerous factual issues regarding Clark’s documented suicide risk, Kuehn and Walker’s knowledge of that risk and who was responsible for initiating the jail’s suicide prevention protocol, but held summary judgment was not the appropriate forum for the resolution of those issues.

Therefore, the Court of Appeals affirmed the district court’s denial of summary judgment. The defendants filed a petition of certiorari with the Supreme Court on December 15, 2017, which remains pending. See: Estate of Clark v. Walker, 865 F.3d 544 (7th Cir. 2017), rehearing and rehearing en banc denied.